Neuroendocrine cervical carcinoma (NECC) is a very aggressive and rare disease. To date, only 2 prospective studies with scarce patient numbers have been reported in the literature. Here we studied a NECC patients (pts) cohort treated with current anticancer treatment modalities.
All pts with NECC were retrieved from 1996 to 2013 in our institute (n = 14). 3D-conformal radiation therapy combined to concomitant chemotherapy (RT-CT) was performed to all pts. Chemo- regimen (CT) was cisplatin plus etoposide or carboplatin plus etoposide. Mean total dose to clinical target volume (CTV) was 48 Gy.
Pts and treatments characteristics. Mean age was 48.5 years old. Most of pts had a loco regional disease (n = 11): stage IA (n = 1), IB (n = 1), IIA (n = 2) and IIB (n = 7); 3 pts were stage IVB. Pelvic and/or lombo-aortic lymph nodes involvement was observed in 42.8% pts (n = 6). Among them, 3 pts were treated with an extended lombo-aortic radiation field. Among the entire cohort, 2 treatment modalities were distinguished: (i) most of pts were treated with neoadjuvant CT followed by concurrent RT-CT (n = 9). Either pulsed-dose rate (PDR) brachytherapy (n = 4) or colpo-hysterectomy (=3) was performed according to tumor response. Adjuvant CT was performed to 3 pts in this subgroup (mean number of cycle: 3); (ii) colpo-hysterectomy followed by concomitant RT-CT and PDR brachytherapy (n = 1), adjuvant CT delivered to 1 patient (3 cycles). Pts outcome. Median follow up was 10 years (range, 0.3-11.2). Median overall survival (OS) was 1.9 years; (IC95% [0.8 –NC]); 1-, 2- and 5-y OS were 79%, 48% and 40% respectively. Median progression free survival (PFS) was 11.7 months (IC95% [6 - 59]); 1-, 2- and 5- y PFS were 50%, 29% and 21% respectively. At the time of study analysis, 5 pts were still alive without any progression disease and are considered as long patient survivor (follow up at least more than 6 years).
Despite the small number of pts in our study, pts outcome was consistent with the literature. This study showed a large variety of treatment modalities. To date, there is no consensus on how to treat these pts. However, owing to poor pts outcome, aggressive treatment modalities are probably required.
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All authors have declared no conflicts of interest.